Caregiving Satisfaction, Psychological Distress and
\nCaregiver Burden in Family Caregivers of Dependent Older
\nPeople: A Longitudinal Study

Background and Objectives:
\nAlthough a substantial amount of research has focused on negative aspects of caregiving, less research has been conducted investigating positive aspects of providing informal care. The aim of this study was to investigate the longitudinal association between caregiving satisfaction and psychological distress in informal carers of dependent older people, and whether this relationship is mediated by caregiver burden.
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\nResearch Design and Methods:
\nProspective longitudinal study with a probabilistic sample of 332 caregivers of older relatives, with data collected at baseline and at 1-year follow-up. We measured caregiving satisfaction, psychological distress, subjective caregiver burden and several covariates (caregivers' sex, age and objective caregiver burden). Data were analysed using generalised estimation equations with multiple imputation. The STROBE checklist was used to support the writing of this document.
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\nResults:
\nAfter controlling for covariates, caregiving satisfaction was significantly negatively associated with lower levels of subjective caregiver burden (B = −0.17, 95% CI: −0.23, −0.11) and emotional distress (B = −0.23, 95% CI: −0.36, −0.11). When subjective burden was included in the model, the relationship between caregiving satisfaction and psychological distress was no longer significant (B = −0.11, 95% CI: −0.23, 0.02), whereas the association between subjective burden and psychological distress remained (B = 0.75, 95% CI: 0.57, 0.92). The Sobel test confirmed these results (p < 0.001), indicating that subjective caregiver burden mediates the relationship between caregiving satisfaction and psychological distress (complete mediation) over time.
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\nDiscussion and Implications:
\nCaregiving satisfaction exerts a longitudinal protective effect on carers' psychological distress via subjective burden. Our findings indicate that interventions aimed at strengthening caregiving satisfaction may play a significant role in maintaining positive mental health outcomes for informal caregivers.